What Is in AHA’s Coding Clinic for HCPCS First Quarter 2026 Release?

The First Quarter 2026 issue of the AHA Coding Clinic for HCPCS newsletter was released March 31, 2026. Let us explore some of the highlights!

Medicare Inpatient-Only List Update

The fourth quarter newsletter is 32 pages long and begins with an update on the Medicare Inpatient-Only (IPO) list, which will be phased out over a three-year period. The IPO has historically identified services payable only in the inpatient setting, for Medicare recipients, due to their complexity, invasiveness, recovery needs, or resource intensity. However, the Centers for Medicare & Medicaid Services (CMS) determined that many of these restrictions no longer reflect current capabilities in hospital outpatient or Ambulatory Surgery Centers (ASC). The Inpatient-Only List will be fully eliminated by CY 2028. 

For CY 2026, 285 procedures were removed from the IPO list, and, as a result, eligibility under both OPPS and the Ambulatory Surgical Center Covered Procedures List (ASC-CPL) has been expanded. This change directly impacts facility coding and ASC reporting. 

The first quarter newsletter includes a table of several examples of procedures removed from the IPO list for CY 2026. The complete list of inpatient only procedures is published in Addendum E of the CY 2026 OPPS/ASC Final Rule. 

2026 Surgery Section CPT Code Update

The newsletter provides an overview of selected 2026 changes to the Surgery Guidelines and to CPT codes within the integumentary system and the musculoskeletal system. The intent is to assist outpatient facility coders with the accurate application of updated coding guidelines and rationale. For 2026, CPT has introduced new and revised coding guidelines throughout the Surgery section, including:

• Clarifications related to the definition of foreign bodies and implant,
• Code revisions in the Integumentary System section, and
• Revisions and new parenthetical notes for codes in the Musculoskeletal System.

For Your Information

HCPCS Level II Codes

The newsletter addresses a subset of the new, deleted, and revised HCPCS Level II codes effective January 1, 2026, including:

• 82 new HCPCS Level II codes,
• 93 deleted HCPCS Level II codes, and 
• 111 revised HCPCS Level II codes. 

New CPT PLA Codes

Finally, the newsletter provides an overview of the recent changes to the CPT Proprietary Laboratory Analyses (PLA) codes, including:

• 28 new codes and
• 4 revised codes. 

These changes have an effective date of July 1, 2026. 

For a full listing of the code changes, see the HCPCS Quarterly Update file.

Ask the Editor

The newsletter includes coding advice for 11 questions on the following topics:

• Aborted Colonoscopy
• Tracheobronchial Y-Stent Placement
• Repair of Nonunion Monteggia Fracture Dislocation
• Endoscopic Dilation of Salivary Duct
• Transnasal Esophagoscopy with Dilation
• Mastectomy with Pectoralis Major Muscle Excision
• Transurethral Resection of Bladder Tumor  
• HCPCS Code C9761
• Steerable Catheter Devices

Please refer to the CPT codebook for additional and comprehensive reporting guidelines and the full list of the code changes on CMS’s website. 

As always, please read the First Quarter 2026 volume of AHA Coding Clinic for HCPCS entirely for the best source of medical coding information.